Andrew M Johnson DDS, PA

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

8388 Issued in NC

Legal business name

ANDREW M JOHNSON DDS, PA

Doing business as

Southpark Pediatric Dentistry

Practice address

2700 Coltsgate Rd
Suite 204
Charlotte, NC 28211-3799

Phone

(704) 749-5700

Fax

(704) 749-5701

NPI assigned

Jul 3, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Andrew M Johnson, DDS

Title

President/Owner

Phone

(704) 749-5700

Specialties & licenses 1

Addresses

Other names 1

• Southpark Pediatric Dentistry Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1246579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246579200000",
    "number": "1346479987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 COLTSGATE RD",
            "address_2": "SUITE 204",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282113799",
            "telephone_number": "704-749-5700",
            "fax_number": "704-749-5701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 COLTSGATE RD",
            "address_2": "SUITE 204",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282113799",
            "telephone_number": "704-749-5700",
            "fax_number": "704-749-5701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREW M JOHNSON DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-03",
        "last_updated": "2009-07-03",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "704-749-5700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NC",
            "license": "8388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southpark Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Beatrice Andres, M.A, LPCA, NCC
• Brittany Lynn Andres, NP
• Tamara Andres
• Wendy Haskell Andres, DPT
• Andrew D. Lyons II, DDS, PA
• Jonathan Andrew
• Andrews Image & Mental Wellness, PLLC
• Anthony Andrews
• Cheryl Andrews, LCMHC-S, LPC, CRC
• Clatoyia Andrews, LCSW

• Pediatric Dentistry in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Pediatric Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.